Agreement between intraoperative and anterior segment optical coherence tomography measurements of the extraocular muscle insertion distance in patients with previous strabismus surgery.

PURPOSE: To evaluate the agreement between anterior segment optical coherence tomography (AS-OCT) measurement of preoperative distance from the limbus to the horizontal rectus muscle insertion and intraoperative measurement in patients who have previously undergone strabismus surgery and required reoperation. METHODS: Subjects from two ophthalmological centers were included. Preoperative AS-OCT was used to measure the muscle insertion from the limbus, and intraoperative measurements were obtained using calipers. Interclass correlation coefficient and Bland-Altman agreement analysis were used. RESULTS: A total of 53 horizontal rectus muscles from 24 patients with previous strabismus surgery were analyzed: 27 medial rectus (MR) and 26 lateral rectus (LR) muscles, including both previously operated and previously unoperated muscles. Average of AS-OCT measurements of MR was 8.54 ± 2.42 mm and intraoperatively was 9.4 ± 3.09 mm. Average AS-OCT for LR was 8.32 ± 2.25 mm and intraoperatively was 9.34 ± 3.73 mm. 63% of MR muscles and 77% of LR muscles were within 1 mm between AS-OCT and intraoperative measurement. Spearman's correlation coefficient showed positive correlation between measures for both MR and LR muscles. The interclass correlation coefficient was 0.79 (95% CI, 0.56-0.90) for MR muscles and 0.70 (95% CI, 0.44-0.85) for LR muscles, with a good agreement. Agreement was better for muscles ≤10 mm from the limbus (which included both previously operated and unoperated muscles) than for muscles found >10 mm from the limbus. CONCLUSIONS: Good agreement was observed between the measurement of limbus-insertion distance obtained by AS-OCT and by intraoperative measurement, especially when the muscle insertion was ≤10 mm from the limbus.

Results of Follow-up in Pediatric Keratoconus Treated With Intracorneal Ring Segments Implantation Alone or in Combination With Corneal Cross-linking.

PURPOSE: To report visual and topographic outcomes of pediatric keratoconus with intracorneal ring segments (ICRS) implantation alone or in combination with accelerated corneal cross-linking (A-CXL). METHODS: A descriptive, retrospective observational study was performed. Medical records of patients younger than 18 years at Fundación Oftalmológica Nacional in Bogotá, Colombia, were reviewed. Demographic data, follow-up time, preoperative and postoperative uncorrected (UCVA) and best corrected (BCVA) visual acuity, manifest refraction, and tomography were evaluated. SPSS software (version 22.0; SPSS, Inc) was used for analysis. RESULTS: Twenty-six eyes of 19 patients with a mean age of 16.5 ± 1.8 years were analyzed, and 16 were boys (84.2%). Median follow-up time was 39.6 months (inter-quartile range [IQR] = 30). Fifteen patients (78.9%) had a history of allergic conjunctivitis. Sixteen eyes (61.5%) received ICRS implantation with A-CXL and 10 eyes (38.4%) received ICRS implantation only. Global results (including ICRS implantation with A-CXL and ICRS implantation only) were: (1) median UCVA of 0.90 logarithm of the minimum angle of resolution (logMAR) (IQR = 0.85) preoperatively improved to 0.54 logMAR (IQR = 0.70) postoperatively; (2) median BCVA of 0.43 logMAR (IQR = 0.39) preoperatively improved to 0.30 logMAR (IQR = 0.26) postoperatively; and (3) median spherical equivalent of -5.37 diopters (D) (IQR = -5.28) preoperatively improved to -4.12 D (IQR = -3.57) postoperatively. There was a reduction in half of the sphere and cylinder. The median maximum keratometry was 54.40 D (IQR = 7.4) preoperatively and 49.80 D (IQR = 5.3) postoperatively. The median asphericity was -1.18 (IQR = 0.70) preoperatively and changed to -0.75 (IQR = 0.68) postoperatively. No patient presented with complications before or after surgery. CONCLUSIONS: ICRS implantation only or in combination with A-CXL induced visual and topographic improvement in patients with keratoconus, which was maintained throughout the follow-up time. It seems to be a safe procedure to delay or avoid corneal transplantation in the pediatric population. [J Pediatr Ophthalmol Strabismus. 2022;59(2):118-127.].

Measurement of Practices-Knowledge-Attitudes of the Nursing Process: Systematic Review.

OBJECTIVES: To analyze the literature available on the psychometric properties of the instruments to measure knowledge, attitudes, and practices of the nursing care process. METHODS: This was a narrative-type review conducted by following the recommendations of the PRISMA declaration. The search strategy was executed in two stages; through the search in databases by two reviewers and - thereafter - three reviewers identified independently the studies and evaluated the methodological quality of the measurement instruments by using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) property checklist boxes. RESULTS: Of 71 studies identified for the full-text review, only seven complied with the inclusion criteria that represent four instruments (Q-DIO, D-CATCH, NP-CDSS, PNP). It was found that the instruments continue in their validation and appropriation processes to reality in health services. CONCLUSIONS: In spite of the evident evolution of the instruments to evaluate the implementation of the nursing care process, the need is still valid for an instrument that measures aspects of knowledge, attitudes, and practices in every stage of the process.

Preparación de la piel para la prevención de la Infección del Sitio Operatorio: Revisión de Alcance / Skin Preparation for the Prevention of Surgical Site Infection: A Scoping Review

Introducción: La Infección del sitio operatorio genera un impacto económico y social debido a los altos costos durante la recuperación, la estancia hospitalaria y la afectación de la calidad de vida, por esto, es necesario identificar las intervenciones y recomendaciones para la preparación de la piel, encaminadas a la prevención de la infección del sitio operatorio, basado en la evidencia científica. Materiales y Métodos: Se realizó una revisión sistemática de alcance en el marco del Instituto Joanna Briggs y los parámetros Prisma-P. En las bases de datos Medline, OVID, Pubmed, Scielo, BVS y Cochrane, publicadas entre los años 2010­2019, en los idiomas inglés, portugues y español. Resultados: Se analizaron 28 artículos. De estos, se identificaron 6 de la categoría general incluidas las guías de prevención de infección del sitio operatorio, 6 para el baño preoperatorio, 6 para la realización del rasurado y 10 de asepsia y antisepsia. Discusión: Con respecto al baño preoperatorio, es una práctica recomendada internacionalmente, la evidencia demuestra que esta actividad no representa ningún beneficio; en la categoría de rasurado, la recomendación es no remover el vello a menos que sea absolutamente necesario. Frente a la asepsia del sitio quirúrgico, el aporte es más que todo informativo acerca de los antisépticos y se recomienda el uso de la clorhexidina. Conclusiones: De acuerdo a la revisión sistemática de alcance de la literatura, no se evidencia una estandarización en las recomendaciones e intervenciones, para la preparación de la piel en la prevención de Infección del Sitio Operatorio.

Abstract Introduction: Surgical Site Infections have an economic and social impact due to high costs during recovery, hospital stay and deterioration in quality of life. Therefore, it is required to identify interventions and recommendations for skin preparation aimed at preventing surgical site infection based on a scientific evidence-based approach. Materials and Methods: A systematic scoping review was conducted on English, Portuguese and Spanish articles published in Medline, Ovid, PubMed, Scielo, BVS, and Cochrane in 2010-2019 using the Joanna Briggs Institute approach and Prisma-P parameters. Results: After analyzing a total of 28 articles, 6 articles were found to be related to the general category (including guidelines for prevention of surgical site infection), 6 for preoperative bathing, 6 for preoperative hair removal and 10 for asepsis and antisepsis. Discussion: Although preoperative bathing is an internationally recognized practice, scientific evidence shows that this activity does not have any benefit. As for preoperative hair removal, it is not recommended except where absolutely necessary. As for surgical asepsis, mostly informative aspects are found about the use of antiseptics and chlorhexidine. Conclusions: Based on the systematic scoping review of the literature, a lack of standardization was found regarding interventions and recommendations for skin preparation for the prevention of Surgical Site Infection

Introdução: A Infecção do Local Operatório gera impacto econômico e social devido aos altos custos durante a recuperação, internação e o impacto na qualidade de vida, portanto, é necessário identificar as intervenções e recomendações para o preparo da pele, visando à prevenção de cirurgias da infecção local operativo, com base em evidências científicas. Materiais e Métodos: Uma revisão sistemática de alcance foi realizada dentro da estrutura do Instituto Joanna Briggs e dos parâmetros Prisma-P. Nas bases de dados Medline, OVID, Pubmed, Scielo, BVS e Cochrane, publicadas entre os anos 2010-2019, nos idiomas inglês, português e espanhol. Resultados: Foram analisados 28 artigos. Destes, 6 foram identificados na categoria geral, incluindo as diretrizes de prevenção de infecção de local cirúrgico, 6 para o banho pré-operatório, 6 para barbear e 10 para assepsia e antissepsia. Discussão: Em relação ao banho pré-operatório, é uma prática recomendada internacionalmente, as evidências demonstram que esta atividade não representa nenhum benefício; na categoria de barbear, a recomendação é não remover os pelos, a menos que seja absolutamente necessário. Dada à assepsia do local cirúrgico, a contribuição é principalmente informativa sobre os antissépticos e recomenda-se o uso da clorexidina. Conclusões: De acordo com a revisão sistemática do alcance da literatura, não há evidências de uma padronização nas recomendações e intervenções, para o preparo da pele na prevenção da Infecção do Local Operatório.

Preparación de la piel para la prevención de la Infección del Sitio Operatorio: Revisión de Alcance / Skin Preparation for the Prevention of Surgical Site Infection: A Scoping Review / Preparação da pele para a prevenção da infecção do sítio operatório: revisão do escopo

Resumen Introducción La Infección del sitio operatorio genera un impacto económico y social debido a los altos costos durante la recuperación, la estancia hospitalaria y la afectación de la calidad de vida, por esto, es necesario identificar las intervenciones y recomendaciones para la preparación de la piel, encaminadas a la prevención de la infección del sitio operatorio, basado en la evidencia científica. Materiales y Métodos Se realizó una revisión sistemática de alcance en el marco del Instituto Joanna Briggs y los parámetros Prisma-P. En las bases de datos Medline, OVID, Pubmed, Scielo, BVS y Cochrane, publicadas entre los años 2010-2019, en los idiomas inglés, portuges y español. Resultados Se analizaron 28 artículos. De estos, se identificaron 6 de la categoría general incluidas las guías de prevención de infección del sitio operatorio, 6 para el baño preoperatorio, 6 para la realización del rasurado y 10 de asepsia y antisepsia. Discusión Con respecto al baño preoperatorio, es una práctica recomendada internacionalmente, la evidencia demuestra que esta actividad no representa ningún beneficio; en la categoría de rasurado, la recomendación es no remover el vello a menos que sea absolutamente necesario. Frente a la asepsia del sitio quirúrgico, el aporte es más que todo informativo acerca de los antisépticos y se recomienda el uso de la clorhexidina. Conclusiones De acuerdo a la revisión sistemática de alcance de la literatura, no se evidencia una estandarización en las recomendaciones e intervenciones, para la preparación de la piel en la prevención de Infección del Sitio Operatorio.

Abstract Introduction Surgical Site Infections have an economic and social impact due to high costs during recovery, hospital stay and deterioration in quality of life. Therefore, it is required to identify interventions and recommendations for skin preparation aimed at preventing surgical site infection based on a scientific evidence-based approach. Materials and Methods A systematic scoping review was conducted on English, Portuguese and Spanish articles published in Medline, Ovid, PubMed, Scielo, BVS, and Cochrane in 2010-2019 using the Joanna Briggs Institute approach and Prisma-P parameters. Results After analyzing a total of 28 articles, 6 articles were found to be related to the general category (including guidelines for prevention of surgical site infection), 6 for preoperative bathing, 6 for preoperative hair removal and 10 for asepsis and antisepsis. Discussion Although preoperative bathing is an internationally recognized practice, scientific evidence shows that this activity does not have any benefit. As for preoperative hair removal, it is not recommended except where absolutely necessary. As for surgical asepsis, mostly informative aspects are found about the use of antiseptics and chlorhexidine. Conclusions Based on the systematic scoping review of the literature, a lack of standardization was found regarding interventions and recommendations for skin preparation for the prevention of Surgical Site Infection

Resumo Introdução A Infecção do Local Operatório gera impacto econômico e social devido aos altos custos durante a recuperação, internação e o impacto na qualidade de vida, portanto, é necessário identificar as intervenções e recomendações para o preparo da pele, visando à prevenção de cirurgias da infecção local operativo, com base em evidências científicas. Materiais e Métodos Uma revisão sistemática de alcance foi realizada dentro da estrutura do Instituto Joanna Briggs e dos parâmetros Prisma-P. Nas bases de dados Medline, OVID, Pubmed, Scielo, BVS e Cochrane, publicadas entre os anos 2010-2019, nos idiomas inglês, português e espanhol. Resultados Foram analisados 28 artigos. Destes, 6 foram identificados na categoria geral, incluindo as diretrizes de prevenção de infecção de local cirúrgico, 6 para o banho pré-operatório, 6 para barbear e 10 para assepsia e antissepsia. Discussão Em relação ao banho pré-operatório, é uma prática recomendada internacionalmente, as evidências demonstram que esta atividade não representa nenhum benefício; na categoria de barbear, a recomendação é não remover os pelos, a menos que seja absolutamente necessário. Dada à assepsia do local cirúrgico, a contribuição é principalmente informativa sobre os antissépticos e recomenda-se o uso da clorexidina. Conclusões De acordo com a revisão sistemática do alcance da literatura, não há evidências de uma padronização nas recomendações e intervenções, para o preparo da pele na prevenção da Infecção do Local Operatório.

Measurement of Practices-Knowledge-Attitudes of the Nursing Process: Systematic Review / Medición de prácticas-conocimientos-actitudes del proceso de enfermería: Revisión sistemática / Medição das práticas, conhecimentos e atitudes do processo de enfermagem: revisão sistemática

Objective. To analyze the literature available on the psychometric properties of the instruments to measure knowledge, attitudes, and practices of the nursing care process. Methods. This was a narrative-type review conducted by following the recommendations of the PRISMA declaration. The search strategy was executed in two stages; through the search in databases by two reviewers and ­ thereafter ­ three reviewers identified independently the studies and evaluated the methodological quality of the measurement instruments by using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) property checklist boxes. Results. Of 71 studies identified for the full-text review, only seven complied with the inclusion criteria that represent four instruments (Q-DIO, D-CATCH, NP-CDSS, PNP). It was found that the instruments continue in their validation and appropriation processes to reality in health services. Conclusion. In spite of the evident evolution of the instruments to evaluate the implementation of the nursing care process, the need is still valid for an instrument that measures aspects of knowledge, attitudes, and practices in every stage of the process

Objetivo. Analizar la literatura disponible sobre las propiedades psicométricas de los instrumentos para medir Conocimientos, Actitudes y Prácticas del Proceso de Cuidado de Enfermería. Métodos. Revisión de tipo narrativa según las recomendaciones de la declaración PRISMA. La estrategia de búsqueda se realizó en dos etapas; a partir de la búsqueda en bases de datos por parte de 2 revisores y, posteriormente, tres revisores identificaron de forma independiente los estudios y evaluaron la calidad metodológica de los instrumentos de medición utilizando la COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Resultados. De 71 estudios identificados para la revisión de texto completo, solo 7 cumplieron los criterios de inclusión que representan 4 instrumentos diferentes (Q-DIO, D-CATCH, NP-CDSS, PPE). Se encontró que los instrumentos continúan en procesos de validación y apropiación de los mismos a la realidad en los servicios de salud. Conclusión. A pesar de la evidente evolución de los instrumentos para evaluar la implementación del Proceso de Cuidado de Enfermería, aún sigue vigente la necesidad de un instrumento que mida los aspectos de Conocimientos, Actitudes y Prácticas en todas las etapas del proceso.

Objetivo. Analisar a literatura disponível sobre as propriedades psicométricas dos instrumentos de medida de Conhecimentos, Atitudes e Práticas do Processo de Cuidar de Enfermagem. Métodos. Revisão narrativa realizada de acordo com as recomendações da declaração PRISMA. A estratégia de busca foi realizada em duas etapas; por meio da busca nas bases de dados CINAHL, MEDLINE, BVS e Google Scholar por 2 revisores e, posteriormente, três revisores identificaram os estudos de forma independente e avaliaram a qualidade metodológica dos instrumentos de medição usando a COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Resultados. Dos 71 estudos identificados para revisão de texto completo, apenas 7 preencheram os critérios de inclusão representando 4 instrumentos diferentes (Q-DIO, D-CATCH, NP-CDSS, PPE). Constatou-se que os instrumentos continuam em processos de validação e apropriação dos mesmos à realidade nos serviços de saúde. Conclusão. Apesar da evidente evolução dos instrumentos de avaliação da implementação do Processo de Cuidar em Enfermagem, persiste a necessidade de um instrumento que mensure os aspectos de Conhecimento, Atitudes e Práticas em todas as etapas do processo

Intimal sarcoma of the pulmonary artery presenting as pulmonary embolism / Sarcoma de la íntima de la arteria pulmonar que se presentó como embolismo pulmonar / O sarcoma da íntima da artéria pulmonar, que se apresentou como um quadro de embolia pulmonar

SUMMARY Pulmonary artery sarcomas are extremely rare; due to their insidious growth, diagnosis occurs late and prognosis is poor. We present the case of a 33-year-old woman with a history of dyspnea, chest pain and syncope. An obstructing mass on the right ventricle, main pulmonary artery and right branch were interpreted as a possible pulmonary embolism.

RESUMEN Los sarcomas de la arteria pulmonar son extremadamente raros; debido a su crecimiento lento y silencioso, el diagnóstico suele ser tardío y son de mal pronóstico. Presentamos el caso de una mujer de 33 años de edad con historia de disnea, dolor torácico y síncope. Una masa que obstruía el ventrículo derecho, el tronco pulmonar y la arteria pulmonar derecha llevó a la sospecha de embolismo pulmonar.

RESUMO Os sarcomas da artéria pulmonar são extremamente raros devido ao seu crescimento lento e silencioso, o diagnóstico normalmente é tardio e são de mal prognóstico. Apresentamos um caso de uma mulher de 33 anos de idade com história de dispneia dor torácica e desmaios. Uma massa que obstruía o ventrículo direito, tronco pulmonar e artéria pulmonar direita levou à suspeita de embolia pulmonar

Carga de enfermedad en años de vida ajustados por discapacidad del cáncer gástrico en Colombia / Disease Burden of Gastric Cancer in Disability-Adjusted Life Years in Colombia

Resumen Objetivo: el cáncer gástrico es la segunda causa de muerte por cáncer y la quinta neoplasia más frecuente en el mundo. En Colombia, es la primera causa de mortalidad por cáncer. La incidencia y mortalidad anuales son 16,3 y 14,2/100 000 habitantes, respectivamente. El objetivo de este estudio fue estimar su carga de enfermedad, medida en años de vida ajustados por discapacidad (AVAD), en Colombia. Métodos: se desarrolló un estudio con enfoque en prevalencia para el año 2014. Para estimar la prevalencia, se realizó una búsqueda en los registros del Sistema de Información en Protección Social (SISPRO) y el Departamento Administrativo Nacional de Estadística (DANE). La duración promedio de los casos prevalentes y la sobrevida estimada se obtuvieron de la literatura local. Los AVAD fueron calculados sumando los años de vida perdidos por muerte prematura (AVPM) y los años de vida vividos con discapacidad (AVVD), según la metodología de la Organización Mundial de la Salud (OMS). Resultados: las prevalencias estimadas para 5 años en población mayor de 15 años fueron 40,9/100 000 en mujeres y 62,5/100 000 en hombres. El total de AVAD fue 293,418, con una tasa de 623/100 000 habitantes, de los cuales el 97,4% corresponde a AVPM. La tasa de AVVD y AVPM para Colombia fue 16 y 607/100 000, respectivamente. Conclusiones: los datos obtenidos de SISPRO y el DANE estiman una alta carga de enfermedad en Colombia. Es necesaria la implementación de estrategias de detección temprana del cáncer para disminuir la carga de la enfermedad y mejorar el pronóstico de los pacientes.

Abstract Objective: Gastric cancer is the second most common cause of cancer death and the fifth most common neoplasm in the world. In Colombia, it is the leading cause of cancer mortality. The annual incidence and mortality are 16.3/100,000 and 14.2/100,000 inhabitants respectively. The aim of this study was to estimate the disease burden in Colombia as measured in disability-adjusted life years (DALYs). Methods: This study focuses on prevalence in 2014. To estimate prevalence, a search was made in the registries of the Social Protection Information System (SISPRO) and the National Administrative Department of Statistics (DANE). The average duration of cases and estimated survival were obtained from the local literature. DALYs were calculated by adding the years of life lost due to premature death (YLLs) and years of life lived with disability (YLD) according to the methodology of the World Health Organization (WHO). Results: Prevalences estimated for five years in the population older than 15 years were 40.9/100,000 for women and 62.5/100,000 for men. The total DALY was 293,418, with a rate of 623/100,000 inhabitants; 97.4% correspond to YLL. The YLD and YLL for Colombia were 16/100,000 and 607/100,000, respectively. Conclusions: Data obtained from SISPRO and DANE estimate a high disease burden in Colombia. It is necessary to implement early cancer detection strategies to reduce the burden of disease and improve patient prognosis.